A Phase III Study of Nimotuzumab Plus Concurrent Chemoradiotherapy in Loco-regional Esophageal Squamous Cell Carcinoma

NCT ID: NCT02409186

Last Updated: 2016-04-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-03-31

Study Completion Date

2021-12-31

Brief Summary

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Esophageal cancer is the sixth leading cause of cancer death in worldwide. Over the past 2 decades, well-designed clinical trials have documented the clinical benefits of combination of chemotherapy and radiation for localized esophageal cancer, either as primary therapy or in neoadjuvant setting. Paclitaxel, a radiation sensitizer, has important single-agent activity in esophageal cancer. Paclitaxel-based chemoradiation has been the framework for the recent Radiation Therapy Oncology Group (RTOG) trials of nonoperative management of esophageal cancer. Accumulating clinical evidence suggests that Epidermal Growth Factor Receptor (EGFR) represents a viable target in the treatment of esophageal cancer. EGFR expression is associated with poor prognosis. Nimotuzumab binds specifically to EGFR on both normal and tumor cells and competitively inhibits the binding of Epidermal Growth Factor (EGF) and other ligands, such as Transforming Growth Factor-α (TGF-α). Preclinical models have suggested synergy between nimotuzumab, paclitaxel, cisplatin and radiation. For our phase II study in locally advanced esophageal squamous cell carcinoma (ESCC), the combination of cetuximab and chemoradiotherapy has demonstrated both response and survival benefits. Myara et al reported that nimotuzumab plus concurrent chemoradiation therapy (CCRT) was safe and provided statistically significant objective response (47.8%) and disease control rate (60.9%) in nonresectable ESCC. With all these, the investigators plan to study phase III trial.

Detailed Description

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The primary endpoint of this study is overall survival, and the primary hypothesis is the experimental arm will improve median survival time (MST) from 18.2 month to 28.5 month. Assuming bilateral ɑ = 0.05, statistical power of 80%.Each group requires a minimum of 59 cases. Consider the 20% loss factor.The total sample size is 200 cases.It is 100 cases in each group.

Conditions

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Prosthesis Survival

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Nimotuzumab plus chemoradiotherapy

Nimotuzumab:400mg/w,d1, week 1-7 Paclitaxel:45mg/m2, d1, week 1-7 Cisplatin:20mg/m2, d1, week 1-7 Three dimensional conformal RT(3DCRT)/IntensityModulatedRadiationTherapy(IMRT):1.8 Gy/f/day, T59.4 Gy/33f,week 1-7

Group Type ACTIVE_COMPARATOR

Nimotuzumab

Intervention Type DRUG

400mg/w,d1, week 1-7

radiotherapy

Intervention Type RADIATION

Three dimensional conformal RT(3DCRT)/IntensityModulatedRadiationTherapy(IMRT):1.8 Gy/f/day, T59.4 Gy/33f,week 1-7

chemoradiotherapy Paclitaxel

Intervention Type DRUG

45 mg/m2, d1, week 1-7

chemoradiotherapy Cisplatin

Intervention Type DRUG

20 mg/m2, d1, week 1-7

placebo plus chemoradiotherapy

placebo:400mg/w,d1, week 1-7 Paclitaxel:45 mg/m2, d1, week 1-7 Cisplatin:20 mg/m2, d1, week 1-7 Three dimensional conformal RT(3DCRT)/IntensityModulatedRadiationTherapy(IMRT):1.8 Gy/f/day, T59.4 Gy/33f,week 1-7

Group Type PLACEBO_COMPARATOR

radiotherapy

Intervention Type RADIATION

Three dimensional conformal RT(3DCRT)/IntensityModulatedRadiationTherapy(IMRT):1.8 Gy/f/day, T59.4 Gy/33f,week 1-7

chemoradiotherapy Paclitaxel

Intervention Type DRUG

45 mg/m2, d1, week 1-7

chemoradiotherapy Cisplatin

Intervention Type DRUG

20 mg/m2, d1, week 1-7

placebo

Intervention Type OTHER

400mg/w,d1, week 1-7

Interventions

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Nimotuzumab

400mg/w,d1, week 1-7

Intervention Type DRUG

radiotherapy

Three dimensional conformal RT(3DCRT)/IntensityModulatedRadiationTherapy(IMRT):1.8 Gy/f/day, T59.4 Gy/33f,week 1-7

Intervention Type RADIATION

chemoradiotherapy Paclitaxel

45 mg/m2, d1, week 1-7

Intervention Type DRUG

chemoradiotherapy Cisplatin

20 mg/m2, d1, week 1-7

Intervention Type DRUG

placebo

400mg/w,d1, week 1-7

Intervention Type OTHER

Other Intervention Names

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Taixinsheng Paclitaxel Cisplatin

Eligibility Criteria

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Inclusion Criteria

1. Signed written informed consent prior to study entry
2. age:18-70 years
3. Histopathology confirmed primary esophageal squamous cell carcinoma, meet one of the following criteria (AJCC Staging System,2009,Seventh Edition):Cervical esophageal carcinoma(stage II-III);upper thoracic esophageal cancer or chest esophageal cancer that is unsuitable or refuse surgery (stage II-III)
4. The existence of measurable lesions (according to Response Evaluation Criteria in Solid Tumors 1.1)
5. Eastern Cooperative Oncology Group(ECOG)Performance status of 0-1
6. Possible semi-liquid diet
7. If there is a risk of pregnancy, male and female subjects must be effective contraception during treatment
8. Normal bone marrow reserve: neutrophil (ANC) count≥1500/mm3,platelet count≥100,000 /mm3, hemoglobin≥5.6mmol/L(9g/dL)
9. Normal renal function: serum creatinine≤1.5mg/dl and/or calculated creatinine clearance≥ 60ml/min
10. Normal hepatic function: bilirubin level≤1.5×ULN, alanine aminotransferase aspartate transaminase(ASAT)\& ALST≤1.5×ULN
11. Subjects tumor tissue available for the relevant biomarker detection

Exclusion Criteria

1. Previous chest radiotherapy, systemic chemotherapy, and major esophageal surgery
2. Concurrent chronic systemic immune therapy, targeted therapy, anti-vascular endothelial growth factor(VEGF)therapy or EGFR-pathway targeting therapy not indicated in this study protocol
3. Multiple primary carcinomas of the esophagus
4. Pregnancy (confirmed by urine β-HCG) or lactation period
5. Uncontrolled diabetes, hypertension, and severe cardiac or pulmonary disease
6. There are obvious esophageal ulcers, chest and back more than moderate pain, symptoms of esophageal perforation
7. Unable to comprehend the study requirements or who are not likely to comply with the study requirements
8. Patients with distant metastasis
9. Patients with other malignant disease, except for curable non-melanoma skin cancer, cervical carcinoma in situ or malignant disease cure for≥5 years
10. Known grade 3 or 4 allergic reaction to any of the study treatment
11. Peripheral neuropathy \> grade 1
12. Participation in another clinical study within the past 30 days
13. Significant disease which, in the investigator's opinion, would exclude the patient from the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shandong Cancer Hospital and Institute

OTHER

Sponsor Role lead

Responsible Party

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Jinming Yu

President

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jinming Yu, Ph.D, M.D

Role: PRINCIPAL_INVESTIGATOR

Shandong Cancer Hospital and Institute

Xue Meng, Ph.D, M.D

Role: STUDY_DIRECTOR

Shandong Cancer Hospital and Institute

Locations

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Cancer Hospital Chinese Academy of Medical Sciences

Beijing, Beijing Municipality, China

Site Status RECRUITING

Beijing Cancer Hospital

Beijing, Beijing Municipality, China

Site Status RECRUITING

Cancer Hospital of Shantou University Medical College

Shantou, Guangdong, China

Site Status NOT_YET_RECRUITING

The Guangxi Zhuang Autonomous Region Cancer Hospita

Nanning, Guangxi, China

Site Status NOT_YET_RECRUITING

Affiliated Hospital of Zunyi Medical College

Zunyi, Guizhou, China

Site Status NOT_YET_RECRUITING

Fourth Hospital of Hebei Medical University Tumor

Shijiazhuang, Hebei, China

Site Status RECRUITING

Henan Cancer Hospital

Zhengzhou, Henan, China

Site Status RECRUITING

Jiangsu Cancer Hospital

Nanjing, Jiangsu, China

Site Status RECRUITING

Affiliated Hospital of Jiangsu University

Zhenjiang, Jiangsu, China

Site Status RECRUITING

The First Hospital of China Medical University

Shenyang, Liaoning, China

Site Status RECRUITING

Shandong Cancer Hospital and Institute

Jinan, Shandong, China

Site Status RECRUITING

Renji Hospital Shanghai Jiao Tong University School of Medicine

Shanghai, Shanghai Municipality, China

Site Status NOT_YET_RECRUITING

The First Hospital of Zhejiang Province

Hangzhou, Zhejiang, China

Site Status NOT_YET_RECRUITING

Zhejiang Cancer Hospital

Hangzhou, Zhejiang, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Jinming Yu, Ph.D, M.D

Role: CONTACT

13806406293

Facility Contacts

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Lvhua Wang

Role: primary

13601283715

Zongmei Zhou

Role: backup

13801389769

Guangying Zhu

Role: primary

13717999977

Anhui Shi

Role: backup

13901136511

Zhixiong Lin

Role: primary

13829638278

Zhining Yang

Role: backup

13750443575

Xiaodong Zhu

Role: primary

13978873616

Long Chen

Role: backup

13977129168

Hu Ma

Role: primary

18385034657

Xiaoli Gou

Role: backup

15121201843

Chun Han

Role: primary

13831105846

Jun Wang

Role: backup

13931182128

Jianhua Wang

Role: primary

13938278827

Yongshun Chen

Role: backup

15286831671

Jun Zhu

Role: primary

15380882705

Hong Ji

Role: backup

18625155033

Dai Chunhua, PhD

Role: primary

13952850012

Guang Li

Role: primary

13804058616

Jun Dang

Role: backup

13898150850

Xue Meng, Ph.D, M.D

Role: primary

86-531-67626142

Ming Ye

Role: primary

13901814744

Xin Xu

Role: backup

13917978366

Senxiang Yan

Role: primary

13957162839

Haogang Yu

Role: backup

13516721749

Ming Chen

Role: primary

18758875572

Yujin Xu

Role: backup

13858037993

References

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Meng X, Zheng A, Wang J, Wu X, Li G, Zhu J, Ma H, Zhu X, Shi A, Dai C, Yan S, Wang B, Qu Z, Han C, Sun X, Ye M, Fan R, Huerxidan N, Wang X, Yu J. Nimotuzumab plus concurrent chemo-radiotherapy in unresectable locally advanced oesophageal squamous cell carcinoma (ESCC): interim analysis from a Phase 3 clinical trial. Br J Cancer. 2023 Nov;129(11):1787-1792. doi: 10.1038/s41416-023-02388-7. Epub 2023 Oct 20.

Reference Type DERIVED
PMID: 37864049 (View on PubMed)

Other Identifiers

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NXCEL1311

Identifier Type: -

Identifier Source: org_study_id

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